非乙醇中毒性Wernicke脑病的MRI诊断及临床分析

目的探讨非乙醇中毒性Wernicke脑病的MRI影像学特点及临床表现。方法回顾性分析3例非乙醇中毒性Wernicke脑病的临床资料及MRI影像学表现,并结合文献复习。结果 3例患者有精神或意识障碍、眼震或共济失调等不同程度的中枢神经系统症状。MRI表现为Ⅲ、Ⅳ脑室、双侧丘脑内侧、中脑顶盖区及中脑导水管周围对称性的长T1、长T2异常信号。以T2 FLAIR成像及弥散加权成像（DWI）对称性异常高信号影为特征。经补充维生素B1后明显好转2例,1例死亡。结论非乙醇中毒性Wernicke脑病具有特征性MRI表现,T2 FLAIR成像及DWI对其早期诊断具有较高价值。及早补充维生素B1则是治疗的关键。

Clinical analysis and MRI diagnosis of non-alcoholic wernicke encephalopathy

Objective To investigate the clinical and image features of Nonalcoholic Wernicke encephalopathy.Method and Methods The clinical and image datas of 3 patients with Nonalcoholic Wernicke encephalopathy,we analyzed retrospectively.The reference of Wernicke encephalopathy was reviewed.Results Three patients with MRI examinations showed symmetric T1 and T2 hyperintensity signal in the regions surrounding the cerebral aqueduct、Ⅲ、Ⅳ ventricles、encephalocoede and periphery of aqueduct of midbrain on T2WI and FLAIR images.The symmetrical hyperintensity signals of Nonalcoholic Wernicke encephalopathy patients on the brain T2WI,FLAIR and DWI imaging was showed in MRI.Two patients with supplement Vit B1 were cured,one died.Conclusion The clinical manifestation of Nonalcoholic Wernicke encephalopathy is atypical,and MRI imaging is helpful for early diagnosis of Nonalcoholic Wernicke encephalopathy.It is the key treatment to supply the Vit B1 as early as possible.